Do you favor universal health care?

Yes!

No!

This is a topic that should engender a debate. Two of us nearly drove a perfectly topical thread off-topic as we began such a discussion. We are polite here so I hope we can conduct a debate about this topic without casting personal aspersions. Opinions vary among good and qualified people.

I favor universal health care for two reasons:
1) regardless of how it is financed it is invariably cheaper than no care or rationed care;
2) Private insurance is invariably much cheaper for people who don't use the public systems.

I've been out of work for 3 years and I could not afford to carry health insurance after 2 years.

January 27, 2011 @ 1pm: I was rear-ended

Me (car) stopped in traffic hit by an SUV going 35mph+ so guess which vehicle lost

Damage to my car was $10k+

No visible injuries but I ended up physically sore (which has since gone away) but I did have a moderate to severe concussion.

I am still dealing with the concussion headaches, loss of memory, irritability, nightmares, lack of sleep and many other post concussion syndrome symptoms and undergoing numerous medical and mental health/therapy treatments

Had it not been for San Francisco's "Healthy San Francisco" Universal Health care program for city residents*, I would be looking at $50k (and counting) in medial bills which would have to be paid by me before I eventually recouped them when I sue the "nice guy" who hit me.

*I initially sought treatment without insurance but was able to enroll at the same time and everything was retro'd to be covered but if not, I would in simple terms, be screwed

When the US passed ACTA, I was staunchly against it, but lately, I'm not so sure.

First of all, my little anecdotal situations:
1) My sister-in-law in Canada has had some digestive issues (diverticulitis-type stuff, but not quite that severe). She waited an entire day in the office to see her general practitioner since she HAS to be referred to a specialist. Once her GP saw her, she was referred to a specialist. The appointment for the specialist was for 1 month down the road and after she saw the specialist a surgery was scheduled for 6 months later. All the while, she had blood in her stool.
2) My wife had a minor surgery. She called her specialist directly, schedule the appoint for 3 days later (although they had openings sooner), and she was in and out.

All this points to me being all about the US system.

However, I working in insurance regulation and my office is right next to the commissioner in charge of healthcare. Since I try to keep up on healthcare topics and since I'm next to the commissioner, I can tell you one thing: US healthcare is EXPENSIVE. That isn't shocking but the reason it is so expensive is the biggest issue I have.

There are four main players in the healthcare realm: consumers, insurers, hospitals, and doctors. None of these players has any significant control over any of the other players and even if they do, there is little-to-no incentive to exert that control.

Example: Consumers don't control costs because their employer pays most of their premiums and the insurer pays their hospital bills. The doctor doesn't control costs because he gets paid the more testing and surgery he does. The hospital encourages him because if he leaves a stone unturned, they get sued for medical malpractice. The insurer doesn't care because they'll just raise rates and charge the employer more next year.

The main reason I would be ok with government healthcare is that an individual has almost no leverage with the doctor to lower costs. They would rather get a big payout from an insured patient than to negotiate an all-cash transaction. The government on the other hand can negotiate on a huge scale and lower costs that way. (Check out the last paragraph of this column).

On the other hand, bureaucracy would rear it's ugly head. I'm sure they would have some guidelines on what would be covered but that would slowly (or quickly perhaps) grow, which would increase the cost. Do we really need to be paying for octogenarians to be having hip replacement? Why not? The government is paying for it and octogenarians vote.

I suppose I should explain my own views. I have lived in countries that
1) had no formal general health care (The US when I lived there);
2) that have universal care but with multiple private and public regulated providers funded by the state through employer, employee and general tax revenue (France);
3) with universal health care through a state run and managed system (UK and Brazil).

Without question the most expensive and least effective option is the first one. Many people, uninsured, must rely on emergency rooms for routine health care, by far the most expensive way to do that. Further, rationing of treatment is automatic and based on ability to pay. Beyond that such a system, as ahow628 points out, provides no incentive for economy nor accountability for results. The results in outcomes and costs are clear. Life expectancy is lower, chronic diseases more prevalent and treatment more restrictive than in other cases.

The second system generates strong polemic arguments pro and con. The countries that use such systems have generally high life expectancy, lower chronic disease rates and fairly modest costs (in comparison with option 1, that is). People are constantly frustrated by bureaucratic limitations including lack of choice and poor individual case follow-up, among otehr issues, but the systems do work.

The third option drives many people crazy. Any cursory look at Brazil and/or the UK will produce much argument. There are easy criticisms, but a fair number of advantages too. in these systems poor people can get preventative care, which reduces need for emergency services. In the Brazil case, costing ~5% of GDP, every person in the country (citizen or not) has access to free flu shots and other immunizations by simply showing up and asking. The logic is simple; it is cheaper to immunize everyone than it is to treat communicable diseases. Such systems have many problems, not least of which is waiting, and waiting more. That is why in my two cases I have had private health insurance with private sector hospitals and doctors. I now have zero deductible, private rooms if hospitalized (with a bed for a companion and meals tossed in "free"). They also have the latest diagnostic equipment and exotic annual physical exams. I pay less than half what I did a decade ago for more restrictive coverage with long lists of deductibles and limitations in the USA. I also have no forms to fill out for claims, the plan pays directly.

I like the third option quite a lot. In total it costs less even if you choose, as I do, a private option and stay out of the horrible public system. In teh public system everyone does get basic health care. A side effect of that is that i was diagnosed and treated successfully for a chronic disease that had gone undetected in system one for twenty years, despite lots of tests, because the same medical people did not stay with the entire case and examine all the options. Not only that, the MD's make house calls!

Universal without a doubt. I think everyone deserves healthcare and having preventative medicine will decrease the overall cost.

When you get an EOB from your insurance company after a visit/surgery, etc. and you see the total charged for the procedure, less the adjustments of what is not covered and charged back to the provider, you can really see how inflated the system is.

Because I am diabetic and wear an insulin pump insurance is key and I am fortunate that my husband has great healthcare. Should something happen to that coverage I would be in a real pickle.

One example: A good friend recently underwent emergency stent for 98% blockage. While the typical procedure goes through the groin, his doctor did it through his wrist on an outpatient visit. When our friend told his doctor he had never heard of that before, the doctor said it's not done as much in the US but used widely in other countries with Universal. Doctor also said it was due to US insurance companies not wanting to make it easier and cheaper for folks. Makes no sense!

When the US passed ACTA, I was staunchly against it, but lately, I'm not so sure.

First of all, my little anecdotal situations:
1) My sister-in-law in Canada has had some digestive issues (diverticulitis-type stuff, but not quite that severe). She waited an entire day in the office to see her general practitioner since she HAS to be referred to a specialist. Once her GP saw her, she was referred to a specialist. The appointment for the specialist was for 1 month down the road and after she saw the specialist a surgery was scheduled for 6 months later. All the while, she had blood in her stool.
2) My wife had a minor surgery. She called her specialist directly, schedule the appoint for 3 days later (although they had openings sooner), and she was in and out.

All this points to me being all about the US system.

However, I working in insurance regulation and my office is right next to the commissioner in charge of healthcare. Since I try to keep up on healthcare topics and since I'm next to the commissioner, I can tell you one thing: US healthcare is EXPENSIVE. That isn't shocking but the reason it is so expensive is the biggest issue I have.

There are four main players in the healthcare realm: consumers, insurers, hospitals, and doctors. None of these players has any significant control over any of the other players and even if they do, there is little-to-no incentive to exert that control.

Example: Consumers don't control costs because their employer pays most of their premiums and the insurer pays their hospital bills. The doctor doesn't control costs because he gets paid the more testing and surgery he does. The hospital encourages him because if he leaves a stone unturned, they get sued for medical malpractice. The insurer doesn't care because they'll just raise rates and charge the employer more next year.

The main reason I would be ok with government healthcare is that an individual has almost no leverage with the doctor to lower costs. They would rather get a big payout from an insured patient than to negotiate an all-cash transaction. The government on the other hand can negotiate on a huge scale and lower costs that way. (Check out the last paragraph of this column).

On the other hand, bureaucracy would rear it's ugly head. I'm sure they would have some guidelines on what would be covered but that would slowly (or quickly perhaps) grow, which would increase the cost. Do we really need to be paying for octogenarians to be having hip replacement? Why not? The government is paying for it and octogenarians vote.

All in all, I'm kind of in the middle.

Click to expand...

Bolding mine.

There are more than 4 players: Consumers, Health Care Providers (i.e. everybody from doctors to massage therapists to Home health care providers, etc), Insurers (all types: health, life, property for the consmers; liability for the providers), Hospitals (both for profit and public), Government Agencies (in the US every agency from FDA to NIH to VA), Pharma manufacturers, Pharma delivery and consolidators, Fund managers (since they may own significant positions in some of these companies)

The key relationship among these is a financial one. Every event is a financial transaction. Imagine, now, the number of financial transactions generated in the different models described earlier. When you do the math, and examine the amount of bureaucracy involved just to monitor this financial activity, the actual health care costs (i.e. delivery) is actually quite "small".

I am torn on this subject, but having worked at a couple of the Health Care Providers, it is mind boggling how much money is spent on "score keeping".

The last time I had employer-subsidized health insurance was nearly ten years ago. Immediately after 9/11, I was laid off from my job at an international travel company. The loss of employment was, to say the least, unexpected. Continuing my benefits through Cobra was unaffordable. I went nearly five years with no health insurance at all. I can't even describe how stressful it was - I would joke to friends that if I got hit by a bus, I'd better die because a hospital stay would bankrupt me.

I finally got to the point professionally where I could afford health insurance again, but it's become so expensive that I may not be able to continue it much longer. It's nearly as high as my monthly mortgage payment. That's just wrong.

So because of my somewhat precarious situation, I am all in favor of universal health care.

I started to write a serious response about this...but every word was raising my blood pressure.

Here in Canada we have universal health, but it's only universal in that everyone has their hand in trying to get some money for either doing very little, passing the buck, or judging what everyone else is doing.

i think that we should have universal health care . look at it this way, alot of people are dying because they cant afford medical insurance or that they have another helth issue going on. thoes who dont agree need to try to see things from thoes who dont have point of view. what if that was you who might need an liver or heart transplant and you were told that you couldnt get it done because you didnt have enough or ANY funds at all and was left for dead. look young

We may have Universal Health Care in Canada, but hospital wait times as well as appointments to see specialists for serious health conditions can be long. You can be waiting for periods of a few months before you actually see a doctor from the time you were diagnosed. CTVNews.ca reported "For 14 per cent of Canadians, it can take more than three months to see a specialist, and more than four months for 25 per cent of patients needing elective surgery."

This is why many Canadians have opted to have supplemental health insurance.

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I feel like THAT is the key here. Universal Health Care Raises the Bottom. People who have good employment and therefore better benefits or more disposable income are able to supplement their health care, but people who are un/underemployed or starting business or the like are not left to die in the street or lie about their name at the ER.

People are forced to make a budgetary decision "Do I value seeing a specialist in 3 days or Do I value paying my rent" rather than "Do I value any health care or do I value paying my rent" which is much less dramatic a choice.

I personally have MANY issues with ACA (I feel it is a cop out) and does little to empower people. Then Again, I live under Romney-Care, and felt the same way about that.

Is Obamacare the way to do it? I dont think so..... Its already having a negative economic effect where small business owners are keeping their employee count under 50 so they do not have to offer insurance.

And the line that "if you have health insurance through your employer, nothing will change for you" is simply not true. We received a letter from HR saying that our premiums were increasing due to the Affordable Care Act. Of the many reasons cited, they specifically mentioned that children being allowed to remain on their parent's plan (employees) until 26 (or 27, cant remember right now) is costing the company alot of money.

We may have Universal Health Care in Canada, but hospital wait times as well as appointments to see specialists for serious health conditions can be long. You can be waiting for periods of a few months before you actually see a doctor from the time you were diagnosed. CTVNews.ca reported "For 14 per cent of Canadians, it can take more than three months to see a specialist, and more than four months for 25 per cent of patients needing elective surgery."
This is why many Canadians have opted to have supplemental health insurance.

​

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1.First of all the waiting times get longer when the urgency is not there. I had surgery two years ago that was considered non urgent. From the time it was determined I needed the surgery to the day of operation it took 15 days. I live in Ontario. Other provinces have different results.
2.Supplemental health insurance in Canada will not get you better treatment and in fact its against the law to buy your "priority" Health insurance is primarily used to help with the cost of things medical, not to speed up surgery or appointments

Is Obamacare the way to do it? I dont think so..... Its already having a negative economic effect where small business owners are keeping their employee count under 50 so they do not have to offer insurance.

And the line that "if you have health insurance through your employer, nothing will change for you" is simply not true. We received a letter from HR saying that our premiums were increasing due to the Affordable Care Act. Of the many reasons cited, they specifically mentioned that children being allowed to remain on their parent's plan (employees) until 26 (or 27, cant remember right now) is costing the company alot of money.

Click to expand...

I agree with everything you said. To say you are against universal healthcare is like saying you don't care about the environment (which is different than dis/believeing in Global Warming). No one is going to outwardly say they are completely against universal healthcare.

Right now, I am completely against the fiscal implications that Obamacare is putting on the government, small business and the middle class. My company is no longer going to offer insurance ot us. I have always gotten my own insurance (due to my company not covering the plan I want). I am paying a low amount for a high deductible plan while keeping dr visits and other benefits low. I got a letter the other day saying, in January, my premium is more than doubling, dr visits and my deductible are more than tripling, rx costs are quadrupling. Essentially for more than twice the premium, my benefits are going to be less than 1/3 of what they are now.

I'm as healthy as a horse and was diagnosed with a very rare cancer about two months ago and am insanely glad I had health insurance because without it, even with a very healthy income I'd be hurting right now. Yes, people definitely need to lose weight but I think the cost of care is almost just as much of an issue. Drugs shouldn't be advertised during Superbowl half time.

Do I want universal care? Definitely. What we are doing right now is not working and it needs overhaul from every direction. Many can't get care, those of us who can are paying dearly and it's too much of a business.

As someone who is in charge of approving health insurance coverage for my company, I've seen it go up by double digit percentages literally every year. 12%, 15%, 17%, etc. and in 2009 it was 33%. I've changed deduction schemes, changed carriers, done everything possible to keep it affordable. This rise did not start with the ACA as I've been the decision maker for healthcare for 10 years now and it's never gone down, stayed flat or been in line with inflation in my situation.

Everyone has Auto Insurance, it's the law.
Health Care, is not the law,
As for deserving it, no one deserves anything , you need to earn it
Too many feel they deserve everything
The same person who cannot afford insurance, has a cell phone, a vehicle and over eats for the most part.
We all have too much, and very few realize how well off we are.
We need to learn to live responsible. Most health problems are cause by poor choices in life.

I always hate to hear that anyone has cancer, most of the cures are very expensive, and it is on the rise, I see it everyday.

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